Femorodistal bypass using the chemically processed human umbilical vein graft: 9-year experience.
To evaluate patency, limb salvage rates and complications associated with the use of human umbilical vein as an arterial substitute, the authors carried out a retrospective review of 52 femorodistal bypasses performed over 9 years using human umbilical vein. Indications for operation included acute ischemia, rest pain and nonhealing ulceration or gangrene. There were 28 early occlusions, which resulted in a 1-month primary patency rate of 46% and a secondary patency rate of 52%. The primary and secondary patency rates at 1 year were 18% and 19% respectively. The mean limb salvage rate at 1 month was 57% and at 1 year 34%. Three aneurysms occurred (two anastomotic, one graft). Factors found to have a significant effect on patency rates were indication for operation and state of distal runoff. Infection occurred in 6% of grafts and led to amputation in every case. These disappointing results have caused the authors to discontinue use of human umbilical vein as an arterial substitute.
Batt
M
M
Department of Surgery, Hôpital Annexe-République, Centre Hospitalier Universitaire de Nice, France.
Avril
G
G
Gagliardi
J M
JM
Guzman
R
R
Guidoin
R
R
Boas
N
N
Daune
B
B
Hassen-Khodja
R
R
Le Bas
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001705:Bioprosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014471:Umbilical Veins / Q000637:transplantation*; D014654:Vascular Patency